针对全身炎症和败血症的内分泌和代谢变化:一篇综述文章
Syed Faizan Mehdi1, Muhammad Hamza Qureshi1, Salman Pervaiz1
1The Feinstein Institutes for Medical Research/Northwell Health, Manhasset, NY, USA.
Molecular medicine (Cambridge, Mass.)
|January 21, 2025
概括
严重的败血症会破坏多个内分泌轴,包括下丘脑垂体上腺 (HPA) 轴,导致荷尔蒙失衡. 了解这些败血症引起的内分泌变化对于潜在的治疗策略和作为预后指标至关重要.
科学领域:
- 内分泌学 在内分泌学.
- 临界护理医学 临界护理医学
- 病理生理学 病理生理学
背景情况:
- 严重的败血症是一种危及生命的疾病,其特点是多器官功能障碍.
- 败血症期间内分泌功能受到显著干扰,影响了许多激素通路.
- 脑下垂体上腺 (HPA) 轴的功能障碍是严重败血症的常见发现.
研究的目的:
- 审查严重败血症期间各种激素通路的变化.
- 突出内分泌失调在败血症的整体反应中的作用.
- 强调需要进一步研究荷尔蒙变化的必要性,以获得治疗和预后见解.
主要方法:
- 对严重败血症中内分泌变化的现有文献的综述.
- 对荷尔蒙路径变化的分析,包括HPA,HPT和胰岛素-葡萄糖轴.
- 确定关键的激素和代谢因素,涉及到败血症反应.
主要成果:
- 在败血症的急性阶段观察到皮质醇水平升高 (皮质素血症).
- 显著的改变涉及下丘脑垂体甲状腺 (HPT) 轴,生长激素-IGF-1轴和胰岛素-葡萄糖轴.
- 其他受影响的途径包括丁,甲基荷兰胺,雷宁,血管酶,阿尔多素,格林,葡萄糖,下丘脑垂体淋巴状腺 (HGA) 轴和纤维细胞生长因子-21.
结论:
- 荷尔蒙和代谢变化是身体对败血症反应的组成部分.
- 对这些内分泌变化的进一步研究对于开发新疗法至关重要.
- 败血症期间的荷尔蒙特征可以作为有价值的预后指标.
相关概念视频
01:30Inflammatory Response I: Vascular and Cellular
The inflammatory response is the body's defense against infection, injury, or irritation from bacteria, trauma, toxins, or heat. Inflammation helps locate and destroy pathogens and remove damaged tissue elements to heal the body. During this initial phase, fluid, blood products, and nutrients migrate to the injured area, resulting in redness, heat, swelling, ache, and loss of function. Moreover, signs of systemic inflammation include fever, increased WBC count, malaise, anorexia, nausea,...
01:28Inflammatory Response
An inflammatory response is a localized, nonspecific immune reaction that occurs when a tissue is injured. It is characterized by redness, swelling, heat, and pain, which are commonly called the cardinal signs and symptoms of inflammation. Inflammation can sometimes result in a loss of function.
Inflammation can be triggered by various stimuli, such as impact, abrasion, chemical irritation, infections, and extreme hot or cold temperatures. These can damage cells and connective tissue fibers,...
Inflammation can be triggered by various stimuli, such as impact, abrasion, chemical irritation, infections, and extreme hot or cold temperatures. These can damage cells and connective tissue fibers,...
01:21Stress Response System
The stress response system, also known as the fight-or-flight response, is the body's automatic physiological reaction to perceived threats. Hans Selye introduced the concept of General Adaptation Syndrome (GAS) to describe the predictable pattern of changes that occur in response to stress. GAS consists of three sequential stages: alarm, resistance, and exhaustion. This model helps explain how chronic stress can contribute to health problems.
Alarm stage
In the alarm stage, the body's initial...
Alarm stage
In the alarm stage, the body's initial...
01:25Acute Inflammation III: Local and Systemic Effects
Acute inflammation produces a coordinated set of local and systemic changes that limit injury, eliminate pathogens, and initiate repair. These responses arise within minutes of infection, trauma, or chemical insult and are driven by vascular alterations and leukocyte-derived mediators. When the stimulus resolves, the reaction typically abates within days.Local EffectsAt the site of injury, arteriolar vasodilation increases blood flow, resulting in redness and warmth. Simultaneously, increased...
01:12Chronic Inflammation: Introduction
Chronic inflammation is a prolonged, dysregulated immune response that persists for weeks to years when the inciting stimulus is difficult to eradicate or when self‑antigens drive ongoing reactivity. Morphologically, it is defined by mononuclear cell infiltration, progressive tissue destruction, and concurrent attempts at healing via angiogenesis and fibrosis. Compared with acute inflammation, edema is less prominent while cellular infiltration predominates; triggers include persistent...
01:21Acute Pancreatitis II: Pathophysiology
The pathophysiology of acute pancreatitis centers on injury to pancreatic acinar cells, which initiates a cascade of harmful intracellular events.This injury leads to premature activation of trypsinogen to trypsin in the pancreas. Trypsin then activates other digestive enzymes, such as chymotrypsin, elastase, and phospholipase A2, which begin breaking down pancreatic tissue. The resulting autodigestion causes local inflammation, tissue swelling, hemorrhage, and fat necrosis.Injured acinar cells...